Enrollment Counselor Floater

Job Description

Job Description

JOB SUMMARY

The Enrollment Counselor supports patients in gaining and maintaining access to health coverage through education, eligibility screening, and assistance with insurance applications and renewals. This position is primarily focused on ensuring renewals and enrollments are completed efficiently to meet department and organizational goals. The counselor works in a fast-paced environment, maintaining accurate records and coordinating with local, state, and county programs.

Benefits :

• Free Medical, Dental & Vision
• 13 Paid Holidays + PTO
• 403 (B) retirement match
• Life Insurance, EAP
• Tuition Reimbursement
• SEIU Union
• Flexible Spending Account
• Continued workforce development & training
• Succession plans & growth within

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education :

• Certified Application Assistant (CAA Certificate) (Preferred)
• High School Diploma or GED (required)

Experience :

• Bilingual English/Spanish (Required)
• Familiar with Covered CA, Medi-Cal, Medi-Cal for Families
• Must have two years CAA experience
• EHR- Electronic Health Record experience (Preferred)
• PMS- Practice Management System experience (Preferred)

Licensure/Certification :

• Employees are responsible for maintaining individual certifications as required by job function or by law and provide verification and recertification when requested by management.

Additional Requirements:

• Reliable transportation and flexibility to travel between Los Angeles, San Bernardino, and Riverside Counties as needed.
• Flexibility to work evenings and weekends as needed for community events.
• Maintains personal appearance when interacting with patients, staff and physicians.
• Must be able to cope in a “fast pace” environment.

Licensure/Certification :

• Employees are responsible for maintaining individual certifications as required by job function or by law and provide verification and recertification when requested by management.

Language Skills

Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Reasoning Ability

Ability to define problems, collect data, establish facts, and draw valid conclusions. Synthesize complex or diverse information. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Ability to interpret situations, characteristics, behavior, etc. and respond appropriately.

Computer Skills

To perform this job successfully, an individual should have knowledge of MS Outlook, MS Excel, MS Word, and Internet software. Electronic Health Records experience preferred.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Performs a combination, but not necessarily all, of the following duties:

• Assists patients in completing applications and forms for private insurance, Med-Cal, as well as other County or State health insurance programs.
• Assist patients with completing applications and forms for Medi-Cal, private insurance, and other county/state health programs.
• Screen patients for insurance eligibility and provide guidance on available programs and benefits.
• Conduct renewals for Medi-Cal and other programs on an annual or required basis to retain coverage.
• Track enrollment progress and follow up promptly on pending applications or issues.
• Educate patients on financial assistance, sliding fee scales, documentation requirements, and program eligibility.
• Participate in community outreach and enrollment activities as needed.
• Collaborate with clinicians and administrative staff to identify patients who may qualify for financial assistance.
• Maintain accurate documentation in EHR and PMS systems, including prescriptions, patient charts, and communication logs.
• Complete reports including productivity, Medi-Cal, PCP changes, and other compliance-related reporting.
• Attend trainings (e.g., CHAMP-Net) and meetings as directed to stay current on program updates.
• Provide professional, empathetic service to all patients, including those who may not qualify for coverage.
• Demonstrate understanding of organizational policies and procedures and maintain confidentiality in accordance with HIPAA

Responsibility to Team – actively support assigned team/department by participating in and supporting all team/departmental initiatives, proactively communicating with supervision, meeting assigned goals and objectives, and committing to embracing process improvement initiatives.

Responsibility to Organization – actively support SJCH by consistently meeting St. John’s Mission, Vision, and Values; modeling positive interactions with patients, staff, and community; keeping informed of internal (e.g., policies and procedures) and external (e.g., legal or political matters) which may affect business.

Additional Duties – as assigned.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee establishes and maintains effective work relationships with co-workers and customers, maintains regular attendance, understands and carries out a variety of oral and written instructions, has knowledge of proper English usage, grammar, punctuation, spelling, and

vocabulary, has the ability to learn office principles, practices, and methods, understands filing systems, including numerical, alphabetical, and chronological, learns a variety of procedures, policies, and services of the assigned work unit or program, performs assigned duties with efficiency and accuracy and maintains confidentiality. The employee will be working in a normal office environment with exposure to moderate noise, dust, temperature, etc. During community meetings and outreach activities an employee may be subjected to a variety of locations and situations including community centers and large meeting rooms; this may involve varying noise levels, temperature, dust, or other environmental differences.

St John's Community Health is an Equal Employment Opportunity Employer